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Neurofeedback for epilepsy

With electroencephalographic (EEG) biofeedback (or neurofeedback), it is possible to train the brain to de-emphasize rhythms that lead to generation and propagation of seizure and emphasize rhythms that make seizures less likely to occur. With recent improvements in quantitative EEG (qEEG) measurement and improved neurofeedback protocols, it has become possible in clinical practice to eliminate seizures or reduce the amount of medication required to control them.

The use of neurofeedback to treat human epilepsy dates back to the early 1970s [1]. Subsequent studies (without qEEG guidance) showed that seizure frequency could be reduced in most patients who were trained to decrease slow frequencies in the 3- to 8-Hz range and reward frequencies in the 9- to 18-Hz range. Complete abolition of seizures was rare, however. With the development of sophisticated qEEG databases it has become possible to more precisely characterize power and coherence abnormalities associated with drug-resistant epilepsy. If there is focal excessive power in a frequency band, it may be downtrained. If there is a focal deficiency in power, it may be uptrained. Similarly, significantly decreased coherence between brain areas may be uptrained and significantly increased coherences may be downtrained. This approach has been found in clinical experience to decrease or abolish seizures in all patients appropriately trained. Many even become medication free.